Place of nasal decongestants in the treatment of acute infectious rhinosinusitis in children

A.E. Abaturov, E.A. Agafonova, L.L. Petrenko, V.L. Babich

Abstract

Acute infectious rhinosinusitis is the most common clinical form of respiratory pathology in childhood. Despite the fact that in 90 % of cases the main etiological factor leading to the development of rhinosinusitis is viral infection, 13 % of them are complicated by bacterial inflammation. Acute respiratory di­seases with manifestations of rhinosinusitis constantly recurring in the child can lead to the formation of allergic, non-allergic rhinitis and chronic rhinosinusitis — multifactorial chronic inflammatory diseases of the upper respiratory tract. The pathogenesis of acute infectious rhinosinusitis, in spite of the abundance of data, has been underinvestigated. The article highlights the problem of acute infectious rhinosinusitis treatment in children from the standpoint of modern ideas about the development of inflammatory process in the nasal mucosa, the role of innate immunity, and the functioning of mucociliary clearance. Data on the clinical manifestations of acute infectious rhinosinusitis are presented, clinical and diagnostic criteria for its detection are given. The mechanisms of action of nasal decongestants are described, as well as the features of their use, the immunological and anti-inflammatory effects of these drugs. Attention is focused on the mechanisms of action of oxymetazoline. Recommendations for the use of oxymetazoline in pediatric practice are given.